Individual
DR. JASON DESELMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-5095
Mailing address
57950 LEAVENWORTH ST, MCCONNELL AFB, KS 67221-3505
(316) 759-5095
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1312
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
389904
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/12/2006
Last updated
11/19/2025
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